Troise, StefaniaNavarro Cuéllar, CarlosDell´Aversana Orabona, Giovanni2025-04-232025-04-232025-04-12Troise, S., Di Blasi, F., Esposito, M., Togo, G., Pacella, D., Merola, R., Di Crescenzo, R. M., Staibano, S., Abbate, V., Bonavolontà, P., Salzano, G., Nocini, R., Navarro Cuellar, C., & Dell’Aversana Orabona, G. (2025). The Role of Blood Inflammatory Biomarkers and Perineural and Lympho-Vascular Invasion to Detect Occult Neck Lymph Node Metastases in Early-Stage (T1-T2/N0) Oral Cavity Carcinomas. Cancers, 17(8), 1305. https://doi.org/10.3390/cancers1708130510.3390/cancers17081305https://hdl.handle.net/20.500.14352/119602Background/Objectives: Oral cavity carcinomas (OCCs) represent roughly 50% of all head and neck cancers. The risk of occult neck metastases for early-stage OCCs ranges from 15 to 35%, thus the need to develop tools that can support the diagnosis detecting these neck metastases. Inflammatory biomarkers and perineural and lympho-vascular invasion are emerging as effective in this field. The aim of this study is to demonstrate the effectiveness of these parameters to detect occult neck metastases in early-stage (T1-T2/N0) OCCs. Methods: A retrospective analysis was conducted on 81 patients surgically treated for early-stage OCC. For all patients, data regarding TNM, pN status after the histopathological examination, inflammatory biomarkers, and perineural and lympho-vascular invasion have been obtained. A statistical analysis was performed using the receiver operating characteristic (ROC) curve to calculate the optimal cutoff values for SII, SIRI, PLR, and NLR. Results: Fifty-eight patients confirmed N0 status after surgery, while twenty-three resulted pN+. The best cut-off to detect occult neck metastases were PLR 249.30, NLR 13.10, MLR 0.439, SII 1043.12, and SIRI 1.85. The accuracy to detect occult neck metastases was PLR 75%, NLR 81%, MLR 74%, SII 73%, SIRI 70%, perineural invasion 70%, and lympho-vascular invasion 83%. Conclusions: Our results confirm that inflammatory biomarkers and perineural and lympho-vascular invasion are effective in detecting occult neck metastases in early-stage OCCs. The clinical relevance of this study is that these parameters could be used routinely as preoperative tools to support diagnosis and to help surgeons in the decision-making process, particularly regarding surgical indications for neck lymph nodes treatment.engAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/journal article2072-6694https://doi.org/10.3390/cancers17081305https://www.mdpi.com/2072-6694/17/8/1305open access616-006.04oral cavity carcinomaoccult neck metastasesinflammatory biomarkersperineural invasionlympho-vascular invasionCiencias Biomédicas32 Ciencias Médicas